Grant: Project Grant

Subdural hematoma (SDH) is a common condition experienced after head injury. Blood collects on the surface of the brain, causing headaches which can progress to confusion, weakness, or even coma. While surgery is the traditional treatment for SDH, not all patients require immediate treatment to ease pressure on the brain. After surgery, there can be up to 30% chance of more bleeding and the need for repeated surgery. Given this, a medicine capable of reducing the chance of further bleeding and speeding the recovery of the patient is highly desirable. In this study, we will conduct further testing of a commonly used, inexpensive drug called Tranexamic Acid (TXA). While the body stops unwanted and sometimes dangerous bleeding naturally by forming blood clots, TXA stops these blood clots from dissolving, thereby helping to keep bleeding spots plugged. Our pilot study showed that TXA helped speed up patients' recovery; but more rigorous testing on a larger number of patients is necessary to evaluate the effectiveness of TXA in reducing clinically important bleeding and at the same time confirm whether the drug can be used more widely to help improve patient outcomes. In this study, half of the patients will be randomly assigned to take TXA daily, while the other half will take a placebo, regardless of the need for surgery or not. We will assess patient-reported outcomes over time to quantify treatment success, while also taking biological samples, to better understand how this medicine works in SDH patients.